Learning objectives
The purpose of this educational exhibit is to:
To demonstrate the important features of the normal spine which rule out many anomalies.
To describe the classification of spine abnormalities.
To demonstrate the ultrasound appearances of various abnormalities of the spine.
To discuss the tips and tricks in diagnosis.
Background
Spine abnormalities include either defect in bone or spinal cord.
Prenatal USG imaging place very important role in diagnosis,
prognostication,
and management of these abnormalities.
Spinal abnormalities can be broadly classified into 1.
Bony abnormalities 2.
Spina bifida
Spinal Bifida is sub-classified into open and closed types.
Causes for spina bifida are multifactorial.
Role of USG in the spine:
To identify the level of defect & level of cord termination
To measure the size of the sac and size of the skin defect
For characterization...
Findings and procedure details
Normal spine:
The spine should be always evaluated in three planes because few abnormalities are better seen in one particular plane.
High-frequency probe is very useful in the evaluation of spinal cord and fluid column around the cord.
Axial plane shows the ossification centers of vertebral bodies and posterior elements.
Sagittal plane helps in better assessment of sacrum,
cord termination (Fig 1).
Newer techniques: Omni view and VCI (Fig 2) helps in better assessment.
Tips:
Quality of images can be improved by getting a good...
Conclusion
In fetal spine evaluation it’s important to look for normal appearances like fluid column ventral & dorsal to the cord,
conus medullaris termination,
ossification centers carefully,
any deviation from normal gives important clue for diagnosis.
Whenever we find spine anomaly it’s important to assess other same system and other system abnormalities.
References
1.
Paoletti D,
Robertson M,
Sia SB.A sonographic approach to prenatal classification of congenital spine anomalies.Australas J Ultrasound Med2014;17:20–37
2.Tortori‐Donati P,
Rossi A,
Cama A.Spinal Dysraphism: a review of neuroradiological features with embryological correlation and proposal for a new classification.Neuroradiology2000;42: 471–91
3.Tortori‐Donati P,
Rossi A,
Biancheri R,
Cama A.Congenital Malformations of the Spine and Spinal Cord.
In:Pediatric Neurology,
Part 2.
Springer: Berlin Heidelberg: 2005.
Retrieved 18 February 2010 from RMIT library database
4.Bulas D.Fetal evaluation of spine dysraphism.PediatrRadiol2010;40: 1029–37